CORONARY INTERVENTIONS IN EUROPE 1992

The general practice of coronary interventions is influenced by variou s aspects, traditional, cultural, socioeconomic and personal. The aim of this survey was to collect the data on coronary interventions in al l member countries of the European Society of Cardiology. The data fro m 12 of the 35 national members were missing or grossly incomplete and were therefore excluded from the analysis. Coronary angiography The t otal number of coronary angiograms was reported as 683 888, an inciden ce of 1009 +/- 1021 per million inhabitants (range 9 (Romania) to 3076 (Germany,)). Germany (246 115 cases), France (144 754), the United Ki ngdom (76 296), Italy (45 517) and Spain (43 495) registered 81% of al l the coronary angiograms performed. Percutaneous transluminal coronar y angioplasy (PTCA) The total number of reported PTCAs was 147 729, wh ich on average accounted for 19 +/- 11% (range 2 (Lithuania) to 53% (N etherlands)) of the coronary angiograms, Most of the PTCAs (82%) were confined to a single vessel. The highest incidence of multivessel PTCA was reported from Slovakia (28%). PTCA took place immediately after t he diagnostic study in only 18% of cases. Adjusted per capita, Germany ranked first with 703 PTCAs pei million inhabitants, followed by Icel and (619), France (614), Belgium (568) and Austria (485). A major in-h ospital complication was reported in emergency 25% of the patients und ergoing PTCA: 0.4% hospital deaths, 1.0% emergency CABGs and 1.1% myoc ardial infarctions. New devices Stents were implanted in 3211 patients (2.7% of all PTCA patients), equally distributed between emergency si tuations (53%) and elective procedures. Other interventional devices w ere applied in 4133 cases (2.8% of all PTCA cases): directional athere ctomy, rotablator, transminal extraction catheter, laser and Rotacs ac counted for 1452, 1232, 55, 558 and 222, respectively. Coronary ultras ound (1350 cases) and coronary angioscopy (373 cases) were rarely perf ormed Coronary artery bypass grafting (CABG) A total of 63 477 patient s underwent CABG in the reporting centres resulting in a PTCA/CABG rat io of 2.3. A significnnt under-reporting of surgery in the participati ng centres must be assumed. Conclusions Although partial reporting mig ht bias conclusions, several findings of this survey, are noteworthy: (1) PTCA was a well accepted treatment for coronary artery disease, (2 ) PTCA was applied more frequently than CABG, (3) there was an extreme ly wide range of coronary angiography and PTCA performed per million i nhabitants, (4) the most common additional procedure was stent implant ation, but other new devices were only rarely applied.